ABSTRACT
Objective To evaluate the role of thoracic three-dimensional conformal radiotherapy (3DCRT) in patients with extensive-stage small cell lung cancer (ES-SCLC).Methods A total of 171 patients with ES-SCLC admitted from 2004 to 2009 were included in the study.Eighty-six patients received thoracic 3DCRT and systemic chemotherapy (CT),while 85 patients received systemic CT alone.3DCRT was delivered at 1.5 Gy/fraction twice daily or 2.0 Gy/fraction once daily,with a total dose ranging from 40 to 62 Gy.The CT regimen consisted of carboplatin/cisplatin and etoposide.The survival time and survival rate were calculated by the Kaplan-Meier method,and the log-rank test was used for univariate prognostic analysis;the Cox model was used for multivariate prognostic analysis.Results The follow-up rate was 100％.The median overall survival (OS) time and the 2-and 5-year OS rates were 15 months,31.5％,and 2.4％,respectively,for all patients;they were 18 months,35.3％,and 2.4％,respectively,for the CT/3DCRT group,versus 12 months,14.5％,and 2.4％ for the CT group (P =0.023).The median progression-free survival (PFS) time and the 1-and 2-year PFS rates were 8 months,27.5％,and 2.4％,respectively,for all patients;they were 9 months,35.4％,and 6.0％,respectively,for the CT/3DCRT group,versus 6 months,20.5％,and 6.0％ for the CT group (P =0.004).In the CT/3DCRT group,the 22 patients who received 45 Gy at 1.5 Gy/fraction twice daily had a median PFS time of 11 months,versus 9 months for the 26 patients who received 60 Gy at 2.0 Gy/fraction once daily (P =0.037).Multivariate analysis revealed that receiving ≥ 4 cycles of CT (P =0.001) and 3DCRT (P =0.008) were favorable prognostic factors for OS.Conclusions Thoracic 3DCRT can improve the OS and PFS in patients with EDSCLC,and it has good efficacy when delivered with a total dose of 45 Gy at 1.5 Gy/fraction twice daily.Thoracic 3DCRT and receiving ≥4 cycles of CT are independent favorable prognostic factors for OS.
ABSTRACT
Objective To explore the expression of Survivin and MHC in non-small cell lung cancer (NSCLC), and their interaction.Methods A total of 40 patients with histologically diagnosed NSCLC were enrolled in this study.Control samples were consisted of normal lung tissues from 15 patients.Expression of Survivin and MHC were detected by flow cytometry in 40 non-small cell lung cancer tissues and 15 normal lung tissues.Results The positive rates of Survivin protein expression in NSCLC tissues classified stages Ⅰ,Ⅱ and Ⅲ were 28.57% ,30.77% and 80.00% respectively.There was a correlation between Survivin protein expres-sion and stages of NSCLC.Survivin protein expression was detected in 19 of 29 patients with lymph node metas-tasis, and 3 of 11 patients with no metastasis.There was a statistically significant difference between the two groups (P<0.030).The loss expression rates of MHC-Ⅰ in NSCLC tissues of low grade,intermediate grade and high grade were 84.62% ,42.10% and 37.50% respectively.There was a correlation in expression be-tween MHC-Ⅰ and tumor grade.The positive rates of MHC-Ⅱ expression in NSCLC tissues was related to pa-thology type (P=0.005).The expression in squamous cancer and non-squamous non-adno cancer was lower than that of adenocarcinoma (P=0.002, P=0.04).There was no obvious correlation between the expression of Survivin and MHC-Ⅰ,MHC-Ⅱ in NSCLC.Conclution The expression of Survivin and MHC could be in-volved in the pathogenesis and development of NSCLC, and the combined detection will predict the prognosis of the patients with NSCLC.